Introduction: Skull-based osteomyelitis is bony infection which generally originates from inadequately treated chronic infection, adjoining tissue infection or after trauma.Case: 11 month female child had a trivial fall while standing near a bucket. The child developed fracture of right clavicle and left orbital swelling which was inadequately treated. This resulted in in spread of infection to adjoining tissues, skull bones, sinuses and brain.Conclusion: Cranial base osteomyelitis is rare but dreaded condition which requires early diagnosis and prompt treatment to avoid mortality and morbidity in form of neurological deficits and permanent disability

Introduction Epstein-Barr virus (EBV) infection can present with a variety of manifestation. Case Report Here we present a case of a 7 year- old immunocompetent girl who came with acute abdominal pain , had echocardiographic evidence of myocardial dysfunction and finally was diagnosed as a case of serologically proven acute EBV infection. Conclusion Isolated gastrointestinal symptoms can be a presentation of Epstein-Barr virus myocarditis.

Introduction Cri du chat syndrome is a rare genetic disorder due to deletion of variable length of short arm of chromosome 5(5p). It mainly presents with typical cat like cry, facial dysmorphism, poor growth with feeding problems and severe cognitive, speech, and motor delays. Case Report We present here a one year old child who did not presented with typical features but presented with recurrent pneumonia with chronic stridor since early infancy. On evaluation we found short flabby epiglottis and we did karyotyping which showed 5P deletion syndrome. Conclusion Cri du chat syndrome can be presented with atypical features like chronic stridor and recurrent pneumonia without having typical cat like cry. Early diagnosis is necessary for proper counselling of parents and treatment of the patient.

Introduction Constipation is one of the most common causes of referral to pediatric gastroenterology clinics. The histopathology and Immunohistochemistry (IHC) studies indicated that several neurons are currently detectable in motility of the gut. We aimed to evaluate calretinin in the children with chronic constipation. Materials and Methods In this cohort study, 40 children with chronic constipation, 28 boys (70%) and 12 girls (30%) referring to pediatric surgery ward in Shahid Mohammadi Hospital, Bandar Abbas-Iran, between January 2010 to February 2012, were recruited. Then, full rectal biopsy 1.5 cm above dentate line was performed for all children and calretinin immunoreactivity and pattern of staining for ganglion cells (nuclear and cytoplasmic) and also nerve fibers in different layers of the bowel (lamina propria, muscularis mucosa, submucosa, and muscularis propria) were measured. According to their pathologic results, the children were assigned in two groups for treatment: 1- Those with aganglionosis underwent pull- through operation, and 2- Patients with ganglion but abnormality in their immunohistochemistry received botulinum toxin. Results In this study, 9 (23.9%) aganglionic patients with the mean age of 3.6±1.7 years compared with 31 (76.1%) hypoganglionosis patients with the mean age of 3.2±1.2 years were examined. Pull- through operations were carried out for all patients in the aganglionic group, and for 6 (19.4%) patients in the hypoganglionosis group. Postoperative manometry was significantly better in both groups, but monomeric change was not significant between the two groups. Conclusion Our results revealed that calretinin is absent in aganglionic children, moreover we indicated, calretinin IHC is a very useful and valuable technique for detecting aganglionosis in patients with chronic constipation.

Introduction
Domestic violence is one of the most important public health priorities that directly or indirectly impact on pregnancy outcomes. Given the importance of sexuality in pregnancy and its effect on marital relations, this study aimed to investigate the relationship between sexual satisfaction and violence against pregnant women. Materials and Methods
In this cross-sectional study, 430 pregnant women admitted to Fatemiyeh Hospital in Shahroud-Iran, during the first quarter of 2015, after obtaining informed consent, were selected to complete Larson Sexual Satisfaction Scale and ENRICH Marital Satisfaction Scale as well as Domestic Violence questionnaire. Relationships between variables were analyzed using structural equation modeling. Results
The average age of mothers was 28±5.2 years. Prevalence of domestic violence was reported 84.4% in this study. The 55.8% of participants reported physical violence, 81.2% reported emotional violence and 25.3% reported sexual violence. The mean score of marital satisfaction in women with domestic violence (162.5 ± 28.9) was significantly lower than that in pregnant women without domestic violence (188.7 ± 31.4). A significant negative relationship was observed between sexual satisfaction and marital satisfaction with the domestic violence was –0.42 and ‌–0.61, respectively. Conclusion
Considering the high prevalence of domestic violence and its significant relationship with marital satisfaction and sexual satisfaction in this study, interventions and counseling are recommended to increase marital satisfaction and sexual satisfaction and to reduce domestic violence during pregnancy.

Introduction Social physique anxiety (SPA) and Obsessive-compulsive disorders (OCD) are highly correlated and have been considered to be important in understanding eating problems. HoweverSPA and OCD have not been directly studied with respect to eating problems. Thus, the aim of this study was to examine the relationship between SPA and OCD and measures of eating problems.Materials and Methods This cross-sectional analytical study was done on 100 adolescent girls in Isfahan-Iran. The girls completed questionnaires measuring Social physique anxiety scale (SPAS, 17-item), Obsessive-Compulsive Disorders (30- item) and Eating problems (31-item). Data were analyzed by the statistical tests of Pearson correlation coefficient, Student’s t-test, one-way analysis of variance (ANOVA), and regression through SPSS version 14.Results The mean age of students was 15.1+ 2.3, 53% had normal Body mass index (BMI) and 83% of them had moderate economical status. There was a positive correlation between the rate of eating problems symptoms with OCD (P<0.05, r= 0.365). Also, there was a positive correlation between the rate of eating problems symptoms with SPA, too (P<0.05, r= 0.360). Conclusion The results indicate that SPA and OCD appears to be a useful construct for understanding eating problems in girls adolescent.

Introduction Since, employing new education approach is necessary for enhancing medical students` skills, so the aim of this study was to determine the effectiveness of role –play approach compared the traditional method about neonatal admission skills in delivery room among midwifery students. Materials and Methods This was an experimental study in 2013-2014 in Isfahan-Iran. After baseline testing, 30 midwifery students were trained using role-playing method for neonatal admission skills (n=15, case group) and using a traditional method (n=15, control group). Participants were tested after intervention in final term. The collected data was analyzed using SPSS version 13 and descriptive and analysis such as independent t-test and paired test. The significant level was considered less than 0.05. Results Before intervention, the findings did not show any significant difference between skill scores of two groups (role-play and traditional method); while a statistically significant difference was observed in after intervention between the scores of two groups (P=0.003). After intervention, Paired t- test showed a statistically significant difference in skills scores in two groups respectively (P=0.024, P=0.010). Conclusion Role-play teaching technique can be increased neonatal admission management skills levels in midwifery students. So, the conduction of this educational model is recommended as an effective learning in neonatal admission management. The role playing approach leads to comparable practical neonatal admission management-performance compared to traditional method. Therefore, this approach could be useful in special educational settings especial midwifery and neonatal wards.

Introduction
Nurse-patient communication is highly important especially when the patient is a child. One thing that has been overlooked in the nursing profession or less discussed is how to communicate with children. Design and training courses for the development of communication skills is considered as an important step in this direction. This study investigated the effect of training communication skills on children’s nurses through role- playing.
Materials and Methods
This study is a clinical trial with pre-test and post-test which was done on 60 nurses in Dr. Sheikh Hospital in Mashhad-Iran. Nurses were randomly assigned into either intervention or control groups. Nurses' communication skills were measured using the tools of Calgary Cambridge communication skills assessment before and three weeks after the intervention. During one-day workshops, 6 hours of teaching communication skills with children were given to nurses as role playing and based on pre-prepared scenarios.
Results
The results showed there was no significant difference between the two groups in the mean score of nurses' verbal and non verbal communication skills before the intervention (verbal :P=0.302, non verbal :P=0.795). But after the intervention, the mean score of nurses' verbal and nonverbal communication skills in the experimental group were statistically significant and higher than those in the control group (P<0.001).
Conclusion
Now, due to the weakness in the relationship between nurse and child at the bedside and nurses also receive instruction on communication specific skills related to children, it seems essential that the effect of the implementation of various educational practices be examined to nurses' communication skills.

BackgroundPregnancy and delivery are among the most stressful events in women’s life . Breech presentation is defined as a fetus in a longitudinal lie with the buttocks or feet closest to the cervix. This occurs in 3-4% of all deliveries.The risk for perinatal mortality was 1 in 300 for planned breech deliveries.Some conventional non-surgical therapies for breech presentation are available. acupoint (BL67) stimulations are commonly used for the correction of breech presentation. The present study aimed to evaluate the effect of acupressure on fetal wellbeing test results.MethodThis study is a clinical trialthat was conducted in one group and the two-steps.Participantswere pregnant women (primigravida) who were 35 to 18 years that refer to Shahid Beheshti hospital in Isfahan in 2013 to receive routine prenatal care.The 32 pregnant women (32-36 weeks) were randomly selected.They were stimulated immediately after the first Non stress test and before the second test.The researchers’ evaluated and analyzed variables using SPSS software version 20.FindingsMean (SD) age of the subjects was 24/7±2/8 and 93/8% of them was housekeeper. The frequency of reactive Non Stress Test (NST) was same before and after stimulation. The mean time of the tests’ result was decreased after stimulation significantly ( p-value=0.048). ConclusionsAlthough fetal non-stress test result wasn’t influenced by acupressure but this intervention led to shorter testing time to achieve results. In other words, after the intervention, the time it takes to reach a reactive fetal non-stress test is about 2/7 minutes less than the time without intervention.

Introduction Considering the high prevalence of vitamin D deficiency in our country and the importance of blood lipid profile as a protective factor, aim of this study was to investigate the effect of vitamin D supplementation on lipid profile in children 10 to 14 years.Materials and Methods In this controlled clinical trial study, 40 children who were studying on 2014 in Birjand elementary schools were selected and randomly divided into two groups containing 20 participants. Children in both group examined for level of lipid profile and serum vitamin D after and before consumption of drugs (vitamin D supplement and placebo). Questionnaire was used in order to record demographic information. Data was analyzed using SPSS-16 statistical software and statistical tests of Chi-square, Fisher exact test, t-paired, independent-t, and Pearson correlation at significance level of P< 0.05.Results The results showed that in children of intervention group the average of High-density lipoprotein (HDL) serum level and vitamin D was significantly higher after intervention before it (P<0.05); the average of Low-density lipoprotein (LDL) serum level was significantly increased (P<0.05), but there was no significant difference in LDL/HDL ratio, cholesterol and Triglyceride before and after intervention. In control group there was no significant difference between the average of vitamin D and blood lipid profile before and after intervention. Conclusion According to the results of this study there is a significant increase in HDL and LDL after using vitamin D supplement, and suggested more studies with larger sample sizes to be done in this area.